Current ratings for:With a little help from their Virtual friend, older Latino adults get more exercise

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When it comes to getting motivated to exercise and do things that are good for our health, sometimes all it takes is a little help from our friends.

This was certainly the case for a group of older, Latino adults in Northern California: They benefited from the advice and encouragement of a virtual friend – a physical-activity adviser named Carmen, a new study reports.

Individuals who participated in an exercise program guided by the virtual adviser had an eight-fold increase in walking compared with those who did not, according to the study, published online today in the Journal of Health Communication. Led by researchers at the Stanford University School of Medicine, it is believed to be among the first “e-health” studies geared toward a non-English speaking, older-adult population with low literacy.

“The results indicate that a virtual adviser delivering culturally and linguistically adapted physical activity advice led to meaningful four-month increases in walking relative to control among underserved older adults,” the study says. “This interactive technology, which requires minimal language and computer literacy, may help reduce health disparities by ensuring that all groups benefit from ‘e-health’ opportunities.”

The lead author of the study is Abby King, PhD, professor of health research and policy and of medicine, and director of the Healthy Aging Research & Technology Solutions laboratory at the Stanford Prevention Research Center.

Electronic games and programs that promote healthy habits have proliferated in recent years. King studies the effectiveness of those specifically targeted toward older adults and said she believes older adults represent the perfect population for such interventions. “[They] are at particular risk for the chronic diseases that can be positively influenced by reasonably modest improvements in physical activity,” she and her co-authors write in the paper.

This study was based on an earlier study of a successful two-month, physical activity intervention geared toward older, primarily low-income African-Americans. The earlier study, led by Timothy Bickmore, PhD, associate professor at Northeastern University, involved the use of an interactive computer character that simulated face-to-face counseling; participants interacted with the adviser by touching responses shown on the computer screen.

The new study, of which Bickmore is a co-author, targeted another underserved (and often inactive) population: low-income, older, Latino adults. The digital adviser was modified to fit in with local Latino culture and to offer interactions in English or Spanish.

For the trial, King and her colleagues recruited 40 inactive adults, ages 55 and older, from a primarily Latino population in San Jose, Calif. More than 92.5 percent self-identified as Latino, and 81 percent reported an annual household income of less than $50,000. The great majority (92 percent) reported a history of chronic illnesses, with the most common being high blood pressure, high cholesterol and arthritis.

Study participants were randomly assigned to a four-month walking intervention, coached by Carmen the virtual adviser, or to a control group. Those in the intervention program were taught to use a pedometer to track their daily steps. During weekly sessions, Carmen evaluated their pedometer information to provide them with personalized feedback, problem-solving and goal-setting. Participants were encouraged to interact weekly with Carmen, who was made available to them through a computer at a local senior center.

The researchers looked at the change in walking behavior at two months and four months, and also assessed whether the participants were adopting any strategies taught by Carmen. After four months, the researchers found that participants increased the amount of time they walked by an average of about 253 minutes each week – eight times more than the increase in the control group.

The investigators also found that five motivational behavior-change strategies significantly increased over four months for those in the intervention program. These included “understanding the risks of inactivity, committing oneself to being physically active, substituting more active alternatives, rewarding oneself for being physically active and reminding oneself to be physically active,” the study said. These skills, it noted, “have been associated with positive health behavior change in other populations.”

“While we hoped that the culturally tailored, individualized program would appeal to older Latino adults, we were surprised and gratified to see how well the group of participants randomized to receive Carmen-based counseling actually did,” King said.

King also said she was heartened that so many participants requested access to Carmen after the data-collection period of the study was over. The researchers left the computer program at the senior center for an additional 20 weeks, and all but one of the participants assigned to the intervention interacted with Carmen during that time.

The study enrollment was small, but the researchers are encouraged by the results. “We believe that, with some additional development and larger-scale testing, these types of virtual adviser programs have the potential for wide adoption and dissemination throughout other communities,” King said, adding that the virtual adviser could be modified based on the ethnicity of other targeted groups.

King and Bickmore were recently awarded a National Institutes of Health grant to conduct a larger, randomized trial of the program. They plan to assess Carmen’s effectiveness as a personal adviser over a longer time period and identify who might benefit the most from using this type of support. The plan is to deploy Carmen at numerous community centers across the San Francisco Bay Area.

Other Stanford co-authors of the paper include research assistant Maria Ines Campero and Leslie Pruitt, PhD, who was a senior research scientist at the time the study was conducted.

The study was supported by a Public Health Service grant (R21CA127511) from the National Cancer Institute. Information about Stanford’s Department of Health Research and Policy and the Department of Medicine, both of which also supported the research, is available at http://medicine.stanford.edu/.

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‘With a little help from their Virtual friend, older Latino adults get more exercise’

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Those who love to shop are often painted as lonely souls, trying to fill a void by buying — and becoming even more isolated in the process.

Not always so, according to new Dutch research. The relationship of shopping and loneliness can go both ways — and the direction seems to have a lot to do with why you shop, according to researcher Rik Pieters, a professor of marketing at Tilburg University in the Netherlands.

Shoppers who could be described as “happy hedonists” may become less lonely, he found.

“It is not a good idea to shop to become happy or to own more than others, but shopping for the fun of shopping might actually be not a bad idea after all,” he said.

Pieters collected data from more than 2,500 Dutch consumers for six years, interviewing them to evaluate their levels of loneliness and materialism. He obtained information on why they shopped and then studied how everything interacted.

Loneliness can foster materialism, he found, but materialism of the right type can reduce loneliness.

“Overall, materialism led to a small, but significant, increase in loneliness over time,” he said. But he found the type of materialism was important in the effect on loneliness.

People who bought things to raise their social status — “You have more blue jeans than I do, but my house has more square feet” — tended to get more lonely. Those who used stuff as medicine or panaceas — “When I finally own my own 1,200cc motorbike, I will enjoy life and be truly happy” — got even more lonely than the one-uppers, he explained.

However, those who bought for sheer enjoyment — as part of a ”lifestyle of happy hedonism” — did best. “It turns out this latter type of materialism actually reduces loneliness, most likely because the enjoyment spreads to other people,” Pieters said. “There is no bragging, comparison, or envy involved.”

Of course, people may switch back and forth between types of materialism, he said.

The study was published online July 11 in the Journal of Consumer Research and will appear in the December print issue.

Focusing on why people buy is valuable, according to Kit Yarrow, a consumer psychologist at Golden Gate University in San Francisco, who reviewed the findings.

“Part of the misunderstanding we have about this subject has to do with the lack of a consistent definition of ‘materialism,'” she said. “One researcher might be talking about someone that lavishly overspends and is overly devoted to shopping, another might be referring to any sort of appreciation for material goods.”

Materialism is on a continuum, she said. And, as Pieters’ study shows, motivations differ.

“I think there is a tendency to want to demonize shopping and the appreciation of products in our lives,” Yarrow said. “In fact, shopping and products have been part of human life since caveman days. They can be a great source of connection and pleasure, and they can also be misused.”

The subgroups described by Pieters rang true with Meg Meloy, an associate professor of marketing at Penn State University, especially the one-uppers. “It’s well known that if we constantly compare ourselves to other people, we will always come up lacking,” she said.

In her own research, she found that people need an outlet when they are hungry, stressed or busy.

“Talking to someone is one way,” Meloy said. Vigorous exercise is another. But for others, shopping is that outlet.

When she looked at what stressed shoppers bought, even those in a very bad mood didn’t break the bank. Most were likely to buy accessories — such as earrings — or music, not big-ticket items, she said.

Facial plastic surgery may turn back the hands of time, but new research suggests it may not, alas, boost attractiveness.

For this small study, 50 strangers were asked to guess the age and subjectively rank the attractiveness of 49 patients after viewing photos of them either before or after facial plastic surgery.

The bottom-line: Surgical intervention shaved a few years off perceived age but did almost nothing to boost patients’ overall attractiveness.

What’s at issue is patients’ expectations, said study lead author Dr. Joshua Zimm, an attending surgeon at Lenox Hill Hospital and Manhattan Eye, Ear and Throat Institute of North Shore-LIJ Health System in New York City.

“When we’re doing this kind of surgery I’m telling patients that they’ll look fresher, more energetic and less tired, and we have some data in the literature that indicates you will look younger, as we found,” Zimm said. “But clearly I cannot say that they will look more attractive.”

He emphasized, however, that the findings represent the work of just one surgeon and that the study design had limitations. “This is not the final word on the subject,” Zimm said.

“But certainly I think you can take away from this that if you’re looking to have aesthetic facial surgery to look younger, we’ve shown that you will,” he said. “Beyond that … it is not clear that everyone will definitely look more attractive.”

Zimm and his colleagues discussed their findings in the Aug. 1 online edition of the journal JAMA Facial Plastic Surgery.

The team focused on clients at a Toronto private-practice facility who had one or more of the following procedures between 2006 and 2010: face lift, neck lift, upper or lower eyelid lift, and brow-lift. The patients ranged from 42 to 73 years old.

Facial photos were taken before surgery and over a six-month follow-up period post-surgery. Makeup and jewelry were banned from the photo sessions, as were additional cosmetic procedures (such as Botox injections or laser skin resurfacing) between the before-and-after photo sessions.

The raters saw either pre-surgery or post-surgery photos of a patient, but never both. Without knowing the purpose of the study, they were asked to estimate the patient’s age and to rate their attractiveness on a scale of 1 to 10. They were given no criteria for determining attractiveness so as not to influence their thinking.

Although patients were deemed to look three years younger on average after plastic surgery, any bump in attractiveness was deemed statistically insignificant.

Zimm took pains to note that the findings do not reflect a real-world context, in which patients’ relatives and acquaintances will have a very clear frame of reference for assessing both age and beauty. He also suggested that a much larger study would be needed to nail down the impact of facial plastic surgery.

What’s more, asking raters to assess age and attractiveness at the same time might have created a “kind of subconscious attractiveness bias,” Zimm said.

Still, “at the end of the day the goal is to make people happy, so we have to know what’s possible in order to determine if any particular patient is someone I can help,” he said.

But a Chicago plastic surgeon said the study is meaningless in that regard.

“Certainly when I see a new patient I have to decide if what the patient is after is achievable or even realistic,” said Dr. Laurie Casas, a senior clinician educator at the University of Chicago Pritzker School of Medicine. “And it’s a very complex process because the perception of beauty has to be evaluated by both the surgeon and the patient.”

The end game is that they want to look more attractive, but this study doesn’t get me anywhere with that process because it’s impossible to make any sense out of the data,” Casas said.

Without a common understanding of what a 1-to-10 attractiveness score actually means, there’s no frame of reference, she said. “It’s totally subjective, so the results have no meaning,” she said.

If you think turning 40 will bum you out, just wait until you hit your mid-50s — that’s when regrets over unrealized goals really kick in.

But don’t worry, some of your happiest years are still ahead of you. According to a new study at the Centre for Economic Performance at the London School of Economics, there’s not one, but two times in our lives when we’re at the height of joy and satisfaction. One is already likely behind you, but the other is still a ways off on the horizon.

Remember those years just out of college, when you were 23 and still shiny-eyed and optimistic about all of the wondrous possibilities that lay ahead of you? That, say researchers, is one of our most contented and gratified times. Funny, because I’ve been reliving my so-called glory days via Girls lately, and Hannah Horvath and her cronies remind me of just how troubled and backwards my life was back then. I guess the only difference is I didn’t have enough self-awareness and maturity to realize just how many bad decisions I was making. But you know what they say: Ignorance is bliss.

According to the study, which involved 23,161 people between the ages of 17 and 85, we’re terrible at predicting how fulfilled we’ll be in the future. People in their early 20s overestimate their future happiness by an average of 10 percent, until life’s disappointments slowly rub away their bright-eyed enthusiasm and bring expectations down to realistic sizes.

You would think this adjustment would lead to happier times. After all, you know what’s ahead of you and how hard you’ll have to work to get there; you understand yourself better and aren’t as tortured by things like fitting in and feeling normal; you’re well on your way up the career ladder, with Xeroxing and coffee runs a faded memory. You may even have found your life partner and settled into a more comfortable and better-paid existence.

But, say the researchers, none of this seems to amount to much of anything in the grand scheme of our happiness, because we don’t hit our second pinnacle of satisfaction until we’re — gulp — 69! So much for the things that are supposed to matter the most in life, like career, marriage and family. What really brings us peace of mind and contentment is when we can settle into retirement and spend our days sipping iced tea, playing tennis and going on bus tours of Europe with our neighbors. Evidently it’s in those years when we no longer face regret or disappointment.

According to the Daily Mail, this isn’t the first study to come to these findings. Happiness follows a U-shaped curve, peaking in our early 20s and after retirement.

Well, to all you young whippersnappers still in your heyday of hopefulness — and even to those of us in those sad, depressing years in between — there’s a little lesson that will hopefully buoy you in the dark decades of your 30s, 40s and 50s: Try not to bother yourself with regrets. Go after what you want, even if it seems ridiculous and whatever the outcome, be happy that you tried. Research shows that we have more regrets over the opportunities we never sought out than the ones we tried for and failed at. So when your mom tells you not to quit your day job to join the circus, maybe she’s just isn’t feeling so hot about the choices she made in her own life. And eating fire and taming tigers is probably going to be a lot more fulfilling than crunching numbers all day for a big, fat paycheck. But what do I know? I’m just a grumpy 39-year-old with three decades of disappointments ahead of her.

Hypothyroidism

If you often feel sad, sluggish and achy, and you’re constantly struggling with your weight, your thyroid could be the reason why you constantly feel so exhausted. This tiny gland controls how efficiently every cell in your body converts food into energy, and when it goes on the fritz, it can make you feel worn out 24/7.

Rx1: Ask for a TSH test

Over half of the women struggling with hypothyroidism have never been diagnosed or treated, according to researchers at Harvard. To find out if you’re one of them, ask your doctor for the Thyroid Stimulating Hormone (TSH) blood test — a high score means your thyroid is lagging, and your brain is trying desperately to get this gland up to speed. Getting hypothyroidism treated with prescription meds can erase your nonstop need for sleep in as little as 12 weeks.

Rx2: Pair protein with carbs

Eating protein at every meal steadies carbohydrate absorption and prevents massive insulin spikes — a proven thyroid suppressor, say Tufts University researchers. Plus, protein is rich in the amino acid tyrosine, an essential building block of thyroid hormones.Start adding some of these protein-rich foods into your diet: one ounce of nuts, eight ounces of milk or yogurt, one egg or four ounces of poultry, meat or fish.

Depression

If you often feel irritable, anxious or blue, crave sweets and starches and have trouble concentrating, you could be depressed. One of the hallmarks of depression is that sufferers crave lots of sleep — and no amount ever really feels like enough, according to UCLA researchers.

Rx1: Put on your dancing shoes

In a recent British study, depressed women lowered their depression scores by 67 percent after only nine weeks of dancing — an improvement that’s tough to match with any other form of exercise or antidepressant meds. Physical activity prompts the brain to produce feel-good chemicals called endorphins and dancing incorporates mood-boosting rhythm and music, the study authors say. To soothe symptoms of depression, try dancing for 20 minutes, four times weekly, — either with a partner, or alone with a dance workout video you can do solo.

Rx2: Eat “happy” meals

If you eat 16 ounces of fish weekly, and you could cut your risk of depression-triggered sleep problems in half, say Stanford University researchers. “Your brain uses the essential fats in fish to produce antidepressant hormones,” says psychiatrist Norman Rosenthal, M.D., author of The Gift of Adversity. “Even if your diet is otherwise healthy, missing out on these fats can trigger depression, sleep disturbances and nonstop fatigue.”

Heartburn

If you have to sleep long hours to make up for sleeping lightly, nighttime bouts of heartburn could be to blame. According to University of Oklahoma researchers, at least 40 percent of people with acid reflux wake up repeatedly every night — and many of those groggy folks have no idea stomach acid is the culprit — their nighttime mild reflux doesn’t cause a typical burning sensation.

Rx1: Slow your roll

Eating more slowly can cut your risk of sleep-sabotaging heartburn flare-ups in half, and in a recent study at the University of Southern California, just switching to the non-dominant hand while eating was all it took to slow down meal consumption by 30 percent.

Rx2: Add apple cider

Mixing one tablespoon of apple cider vinegar with eight ounces of water and sipping it before meals can soothe even chronic heartburn within 48 hours. “Cider vinegar’s natural acids help food digest and move into the small intestine before it can back up into the esophagus,” explains gastroenterologist Joseph Brasco, M.D., author of Restoring Your Digestive Health. One caveat: use cooking vinegar that has been sitting in the pantry for two years. The active ingredients in cider vinegar are damaged by heat, so pick up fresh, unpasteurized bottle at your local health food store.

Sleep apnea

If you snore loudly, have been told you stop breathing in your sleep or sometimes wake up gasping for air, sleep apnea could be the reason you’re always exhausted. Apnea occurs when the upper airway collapses, triggering dozens — sometimes hundreds — of sleep-disrupting breathing pauses every night.

Rx1: Snooze on your side

When back sleepers roll onto their sides, it takes so much pressure off their chest and airways that their apnea episodes and fatigue are cut in half, Japanese researchers say. “To keep yourself snoozing on your side, tape a tennis ball to the back of your pajamas,” suggests Walter Gaman, M,D., co-author of Stay Young. “It’s cheap, simple to do, and works really well.”

Rx2: Lose weight

It’s not easy, but shedding 15 pounds takes so much pressure off the upper airway that it can cut your apnea episodes in half — reach your goal weight, and your sleep apnea could disappear, say researchers at New Jersey’s Mountainside Hospital. To make weight loss a whole lot easier, enjoy a big breakfast and several hearty morning snacks, then taper off from munching as the day wears on. A study at Virginia Commonwealth University found that when subjects moved more of their calories to the morning, they lost four times more weight than when they followed a strict, low-carb eating plan. The researcher’s best guess: Morning meals improve all-day appetite control, plus they rev up your ability to burn fat for fuel.